Stria tedavisinde lazer. Dr. Sedat Akdeniz Dicle Üniversitesi Tıp Fakültesi, Diyarbakır. Stria tedavisinde kullanılabilen lazerler. Pulsed-Dye Laser (PDL) Excimer Laser Copper-Bromide Laser 1,450-nm Diode Laser 1,064-nm Nd:YAG Laser Fractional Photothermolysis.
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Stria tedavisinde lazer
Dr. Sedat Akdeniz
Dicle Üniversitesi Tıp Fakültesi, Diyarbakır
A) Skin biopsy of normal appearing skin adjacent to striae (elastin, X40). B) An untreated abdominal striae adjacent to the normal skin shown in a (elastin, X4O). C) Biopsy of the same abdominal striae shown in B, 8 weeks after treatment with the 585-nm flashlamp-pumped pulsed dye laser at a fluence of 2.0 f/cm- and a spot size of 7 mm.
McDaniel DH, Ash K, Zukowski M: Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser. Dermatol Surg 22:332–337, 1996
Hematoxylin and eosin stain of mouse skin taken at 4 weeks after the four laser treatment modalities. Collagen fibers in the irradiated sites showed a marked increase in the amount and a significant improvement in the organization with the high affinity for the stain; (A) the 595-nm pulsed dye laser (PDL), (B) 1,320-nm neodymium–yttrium–aluminum garnet (Nd:YAG) laser, (C) 1,064-nm long-pulsed Nd:YAG lasers, (D) 1,064-nm Q-switched laser; A0, B0, C0, and D0 were their respective controls.
Elsaie ML, Baumann LS, Elsaie LT. Striae distensae
(stretch marks) and different modalities of therapy: an
update. Dermatol Surg 2009;35(4):563-573.
Treatment of stretch marks with the 585-nm flashlamp-pumped pulsed dye laser.McDaniel DH, Ash K, Zukowski M. Dermatol Surg. 1996 Apr;22(4):332-7.
Stria tedavisinde 585-nm PDL kullanımı
2 uygulama 3 J/cm2, 10 mm spot size
Striaların yaşı: ort: 6 ay- 20 yıl
Tedavi etkili, koyu tenlilerde pigmentasyon önemli yan etki
Jimenez GP, Flores F, Berman B, Gunja-Smith Z. Treatment of striae rubra and striae alba with the 585-nm pulsed-dye laser. Dermatol Surg 2003;29(4):362-365.
Hypopigmented scars treated with the 308-nm excimer laser. Prominent hypopigmented facial scars present at baseline (A) demonstrated excellent pigment correction following 5 treatments (B). The visual pigment levels began to decline at the 2-month follow-up (C) and returned to near baseline levels at the 6-month follow-up (D)
Striae alba treated with the 308-nm excimer laser. Striae alba on the hip are shown at baseline (A) and following 5 treatments (B), with excellent pigment correction. The cosmetic benefit was maintained to the
2-month follow-up (C).
Striae alba in a dark-skinned patient treated with the 308-nm excimer laser. Striae alba on the abdomen are shown at baseline (A) and following 9 treatments (B), with excellent pigment correction. The cosmetic benefit was well maintained to the 1-month follow-up (C).
Stretch Marks: Treatment Using the 1,064-nm Nd:YAG Laser ALBERTO GOLDMAN, MD, FLA´VIA ROSSATO, MD, AND CLARISSA PRATI, MDDermatol Surg 2008;34:686–692
Lasers in Surgery and Medicine 38:142–149 (2006)Skin Responses to Fractional PhotothermolysisHans-Joachim Laubach, MD,* Zeina Tannous, MD, R. Rox Anderson, MD, and Dieter Manstein, MD
A) Hour 1 after FP (200 H&E). Microthermal zones (MTZ, black outline) with columns of altered collagen (black arrow) can be distinguished. The entire stratum corneum remains intact even above the epidermal MTZs. There is no inflammatory infiltrate around the dermalMTZsyet. B) Hour 1 after FP (200 H&E) vessels in the MTZs are thermally destroyed (white arrows).
Day1 after FP (200H&E).MTZsare outlined in black. Microscopic epidermal necrotic debris (MENDs; black arrows) represents the elimination of thermally damaged keratinocytes. MENDs are loaded with melanin. Subepidermal clefting is evident from 1 hour after FP and lasts up to 5 days (stars). The dermal part of the MTZs appears unchanged from day 1, and shows thermally altered collagen and a lack of nuclear staining. Subtle perivascular inflammatory infiltrate begins to form in the dermis (white arrow).
Day 7 after FP (200—Elastica von Gieson). Theregular candelabra arrangement of elastic fibers persists at alltimes after FP (white arrow). MTZs are outlined in black
Epidermis ve dermiste gelişen mikrotermal hasar kontrollü yara iyileşmesini uyararak dermal kollajen artışını sağlar
Neocollagenesis in thereticulardermisresultingfromthe 1540-nmtreatment. (A) Untreatedstriaeshow an atrophiedepidermiswithdegeneratedandfragmentedcollagenfibers. (B) Onemonthafterthelast of threetreatmentswiththe 1540-nmerbium:glasslaser, significantneocollagenesis is demonstrated.
Increasedamounts of elasticfibersfollowingthe 1540-nmtreatment. (A) Beforetreatment, elasticfibers (darkpurplestain) in thereticulardermisappearfragmentedandsparse in number. (B) Onemonthafterthelast of threetreatmentswiththe 1540-nmerbium:glasslaser, theelasticfibersappearuniformlyincreased in number.
(A) This 40-year-oldwomanpresentedwithwidespread, 12-year-old, pregnancy-relatedverticalstriaealbaacross her lower abdomen. Thispatient had a Fitzpatrick III skin type. (B) Threemonthsafterthelast of fourtreatmentswiththe 10-mm tip of the 1540-nmerbium:glasslaser at energysettingsrangingfrom 45 to 55 mJ/μband a 15-mspulsewidth, thehypopigmentationandtexturalirregularitiesweresignificantlyreducedandthepatient’s skin appeareduniformlysmoothAnothernotablefeature of thispatient’sclinicaloutcomewasthemarkeddecrease in pretreatmenthypopigmentation; takentogether, theseimprovements in pigment andtexturecontributedto an overallsofteningandsmoothing of thestriation-likeappearance of thetreatedregion
(A) This 30-year-oldwomanpresentedwithone-year-oldstriaerubraspanning her breasts as a result of pubertalgrowth. Thispatient had a Fitzpatrick III skin type. (B) Fourmonthsafterthelast of threetreatmentswiththe 10 mm-tip of the 1540-nmerbium:glasslaser at 40 mJ/μband a 15-mspulsewidth, thepinkish-reddiscoloration of thestriaeappearedmarkedlyreduced.